title: Risk factors for diabetic retinopathy in a rural Chinese population with type 2 diabetes: the Handan Eye Study.
abstract: OBJECTIVE
  To describe risk factors associated with diabetic retinopathy (DR) in a population-based sample of rural Chinese with type 2 diabetes.
  
  
  METHODS
  The Handan Eye Study is a population-based cross-sectional study surveyed 6830 Chinese people aged 30+ years from 13 randomly selected villages in 2006-2007. All participants underwent a standardized interview and extensive examinations including ophthalmologic and systemic conditions. Diabetic retinopathy was graded from fundus photographs according to the modified Early Treatment Diabetic Retinopathy Study classification system. Logistic regression models were used to assess risk factors associated with DR.
  
  
  RESULTS
  Of 7577 eligible persons, 6830 (90.4%) participated, of which 5597 (81.9%) had fasting plasma glucose (FPG) data. There were 387 (6.9%) participants with diabetes, and 368 (95.1%) had gradable fundus photographs. The age-standardized prevalence of DR was 43.1%. In multivariable-adjusted logistic regression models for all diabetic participants, independent risk factors for DR were longer duration of diabetes (odds ratio [OR] 3.07, 95% confidence interval [CI] 1.94, 4.85, per 5 years of duration), higher FPG levels (OR 1.17; 95% CI: 1.08, 1.27, per mmol/l increase) and higher systolic blood pressure (OR 1.22; 95% CI: 1.08, 1.37, per 10 mmHg increase). For newly diagnosed diabetes, the only significant factor of DR was higher FPG levels (OR 1.17; 95% CI: 1.05, 1.29, per mmol/l increase).
  
  
  CONCLUSIONS
  In rural Chinese persons with diabetes, longer diabetes duration, hyperglycaemia and elevated blood pressure are risk factors for DR. These findings underscore the importance of controlling classic risk factors for DR in developing countries, where diabetes prevalence is increasing.
authors.affiliation: Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China.
authors.forename: Feng Hua
authors.initials: FH
authors.lastname: Wang
authors.forename: Yuan Bo
authors.initials: YB
authors.lastname: Liang
authors.forename: Xiao Yan
authors.initials: XY
authors.lastname: Peng
authors.forename: Jie Jin
authors.initials: JJ
authors.lastname: Wang
authors.forename: Feng
authors.initials: F
authors.lastname: Zhang
authors.forename: Wen Bin
authors.initials: WB
authors.lastname: Wei
authors.forename: Lan Ping
authors.initials: LP
authors.lastname: Sun
authors.forename: David S
authors.initials: DS
authors.lastname: Friedman
authors.forename: Ning Li
authors.initials: NL
authors.lastname: Wang
authors.forename: Tien Yin
authors.initials: TY
authors.lastname: Wong
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D044466:Asian People / Q000706:statistics & numerical data*; D002681:China / Q000453:epidemiology; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology*; D003930:Diabetic Retinopathy / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012424:Rural Population / Q000706:statistics & numerical data*